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Vaccine 101: Vaccines and the Law

In previous Vaccine 101 installments, we covered the history, ingredients, importance, and global impact of vaccination. Now, in our last installment, we take a look at which vaccines we receive in the United States and at what age. Growing up, I remember going to the doctor for the dreaded “booster shot”. I hated needles and would scream excessively, much to my mother’s embarrassment. While I still hate needles to this day, I now understand the importance of getting these shots as a child.

Required Vaccinations

Every state determines their own vaccination requirements as well as their own exemption laws. Each state decides whether these laws apply to public schools, private schools, and/or daycare facilities. These public health laws decide which vaccines, such as chickenpox or measles, an individual must receive in order to attend school and which reasons are considered acceptable for exemption. What exactly do these laws cover? Vaccination laws determine two things, which vaccines and when.

These laws determine which specific diseases a child must be vaccinated against. For example, the chickenpox vaccine is required by all states at the elementary school level. Other vaccines, like hepatitis B, are not required by all states.When a child enters school they are interacting with multiple people within close quarters. To a bacteria or virus, this looks like a buffet of people to infect, making schools a prime place for disease outbreaks. However, vaccinations before entering school help prevent this by creating herd immunity.

They also determine what level of schooling (childcare, kindergarten, middle, university) individuals must have a given initial vaccination and any required boosters. Many initial vaccinations occur between birth and 6 years of age. As you grow older, vaccines may start to wear off, but boosters, or second doses, help to keep protection going. Boosters may be required up to 18 years of age and later in life as well. Want to see what is required by your state? Check out this handy tool from the CDC.

Vaccination Exemptions

Each state has laws dictating what can and cannot be used as a reason for vaccination exemption. These reasons can be medical, religious, or personal. All 50 states allow for medical exemption from vaccination; reasons can include immunosuppression, allergies to vaccine components or known past adverse reactions to vaccines. Forty-six states allow for religious exemptions. Some states require that a family belong to a certain religious group that has legitimate objections to vaccination in order to be exempt. This may be as simple as a parent signing a form saying they have a religious belief that conflicts. Alternatively, states may be more rigorous and ask parents to formally attest that they do in fact have a real religious conflict with vaccination that is not related to personal, scientific, moral, or philosophical ideas.

Only eighteen states allow for exemption based on personal or philosophical belief. People cite many reasons for opting out of vaccinations, from distrust of pharmaceutical companies to a devotion to natural healing. In some states people have filed suits to overturn laws that eliminate or limit philosophical exemption, such as California’s SB 277. Interestingly, though perhaps not surprisingly, the lowest vaccination rates are seen in states where philosophical exemptions are easy to obtain. These lowered vaccination rates can lead to outbreaks of vaccine-preventable diseases, which can cost $10 billion in healthcare costs per year.

When I first proposed the Vaccine 101 series, I came from a place of advocacy for vaccination. I felt that a lot individuals knew there was controversy surrounding vaccination but did not necessarily know the facts. We began with a trip back in time to where vaccines started followed by common ingredients in vaccines. Then we asked, why vaccinate? We discussed how vaccination is not just for personal gain but for the benefit of one’s community as a whole, followed up with global health and disease eradication by vaccination.

Now we’ve finished with vaccination policy, where we have learned how each state supports the health of its communities through laws that uphold successful vaccination programs. Vaccines are safe, effective, and essential for a society to remain healthy and free from fear of diseases like polio and measles. I hope I’ve convinced you that vaccines will continue to help reduce devastating diseases to plagues of the past.

About the Author

A native Virginian (GO HOKIES!), Caitlin Reeves is a PhD candidate in the Microbiology department studying attachment of the human respiratory pathogen Mycoplasma pneumoniae to its human host. Outside of the lab she can be found planning events for UGA’s Women in Science (WiSci) organization, snuggling with her labradoodle Sherlock, or playing video games despite being a 26 year old “adult”.